<div class="box_2">
    <div class="title reg bold"> 
        <span class="inline-block fleft align_left" style="display: inline"> <h2> Register Now ! </h2> </span>
        <div class="clear"></div>
    </div>



    <form class="form1" id="sale_car" method="post" action="<?= base_url(); ?>member/register/submit/1">
        <p> 
            (*) Marked fields are mandatory, Please provide correct information..
            <span class="color_3 bold">Already member ? Click here to <a href="#">Login</a></span>
        </p>

        <!-- Error Message -->
        <div id="validation">
            <?php echo validation_errors(); ?> 
        </div>
        <?php if ($this->session->flashdata('message')) { ?>
            <div id="message"> <?= $this->session->flashdata('message'); ?></div>
        <?php } ?>
        <!-- End of Error Message -->                                    


        <div class="clear"></div>   
        <div class="rowElem">
            <div class="fleft " style="margin-right: 10px">
                <label><strong>First Name:</strong></label>
                <input name="ind_fname" type="text" size="20" value="<?php echo set_value('ind_fname'); ?>"> </input>
            </div>

            <div class="fleft mid_col" >
                <label><strong>Last Name:</strong></label>
                <span style="float:left" > 
                    <input name="ind_lname" type="text" size="20" value="<?php echo set_value('ind_lname'); ?>"> </input>
                </span>
            </div>
        </div>  

        <div class="rowElem">
            <div class="fleft" style="margin-right: 10px">
                <label><strong>Region:</strong></label>
                <select name="state" onChange="getCity(this.value,'<?= base_url(); ?>','register_get_city');">
                    <option value="" selected="selected"> Region </option>
                    <?php foreach ($location['state'] as $state): ?> 
                        <option value="<?= $state->id; ?>"><?= $state->state; ?></option>
                    <?php endforeach; ?>
                </select>
            </div>

            <div class="fleft mid_col" >
                <label><strong>City:</strong></label>
                <div id="register_get_city">
                    <select name="city">
                        <option value="" selected="selected"> City </option>
                        <option value="" disabled="disabled">----------------</option>
                    </select>  
                </div>
            </div>
            <div class="clear"></div>
        </div> 

        <div class="rowElem">
            <div class="fleft mini_col" style="float: left; width: 90px">
                <label><strong>Area Code:</strong></label>
                <input name="ind_areacode" type="text" size="5" value="<?php echo set_value('ind_areacode'); ?>" style="width: 60px"> </input>
            </div>

            <div class="fleft mid_col" style="float: left; width: 130px">
                <label><strong>Land line No:</strong></label>
                <input name="ind_landline" type="text" size="11" value="<?php echo set_value('ind_landline'); ?>" style="width: 125px"> </input>
            </div>

            <div class="fleft marg_left" >
                <label><strong>Mobile No:</strong></label>
                <input name="ind_mobile" type="text"  value="<?php echo set_value('ind_mobile'); ?>"> </input>
            </div>
            <div class="clear"></div>
        </div>  

        <div class="rowElem">
            <div class="fleft " style="margin-right: 10px">
                <label><strong>Email:</strong></label>
                <input name="ind_email" type="text" size="20" value="<?php echo set_value('ind_email'); ?>" /> 
            </div>

            <div class="fleft mid_col" >
                <label><strong>Confirm Email:</strong></label>
                <span style="float:left" > 
                    <input name="ind_cemail" type="text" size="20" value="<?php echo set_value('ind_cemail'); ?>" /> 
                </span>
            </div>
            <div class="clear"></div>
        </div> 

        <!-- PART --->


        <input name="car_agree" type="checkbox" value="I Agree" id="checkbox" /> 
        &nbsp;<strong><a href="#"> I agree the Terms & Conditions, visitor agreement and privacy policy </a></strong>

        <div class="clear"></div>
        I agree that by clicking the 'Continue' button below I am explicitly soliciting a call from <?= $this->settings_model->get_setting('webtitle'); ?> on my 'Mobile Number' to assist me in completing this transaction.
        <div class="rowElem ">
            <div class="clear"></div>
            <a onClick="document.getElementById('sale_car').submit()" class="inline-block button_search color_1 bold"><span class="inline-block">Continue</span></a>
        </div>
        <div class="clear"></div>

    </form> <!-- END OF FORM -->

</div>




